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Georgia rates for HCPCS 58740

Lysis Of Adhesions Salpinx/Ovary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,239.20 / $5,063.00 / $7,421.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,538.99 / $5,842.74 / $14,965.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$550.00 / $550.00 / $550.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.64 / $1,161.73 / $1,510.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $4,826.00 / $7,889.00